Revision Rhinoplasty (Nose) Surgery

If there are some mistakes made during a rhinoplasty procedure or if the patients are not at all satisfied by the results of the procedure, the only alternate left is revision rhinoplasty. Before going for the revision rhinoplasty procedure, the tissue must be repaired for some time. After this a revision procedure can be done. Considerable  improvements are visible via revision rhinoplasty. It is one of the extremely difficult and random plastic surgery procedure done.  It necessitates an accurate estimation of the deformity, a sound grip of nasal hold up device as well as a soft tissue skin covering. Added to this a sensible assessment of the result must be predicted deeply over a long phase of time. These kind of desired results are generally attained by fair investigation of rhinoplasty surgery results so as to emphasize on the frequent problems and work on them.  There are different kinds as well as levels of dissatisfaction and different means to deal with them.       
A poor surgical technique or a poor judgment on the part of surgeon triggers the need for revision rhinoplasty. However, if the plastic surgeon is idealistic but the patient had higher expectations from surgery, it might lead to a disagreement and hence a need for a revision surgery. Certain cases of difficult rhinoplasty are so complicated that a secondary nasal surgery becomes a necessity. The patient after the primary rhinoplasty might face a physical complication or frustration in structural change. Another reason is that he has an impractical illusion about the miracles of the surgery. A lack of fundamental accord between the surgeon and the patient might result in unsatisfactory results and eventually a revision surgery. 
            If the revision surgery is performed due to any physical complication, the surgeon must accept the fault, ease of the patient emotionally and then move towards the revision surgery. Scheduling visits, proper guidance and follow up visits can make the patient more aware of his/her unrealistic expectation and generally the patient give up the thought of a revision surgery. If there is lack of compassion for the emotional needs of the patient, it might eventually show up in the unaccepted results of the surgery, hence a need for revision surgery.
Saddle nose deformity or concavity of the dorsum of nose is due to the over-projection of nasal tip. It is a result of resection of the cartilage of nose with the bony dorsum. When you go for revision rhinoplasty, particularly in case of dorsal deficiency, the cartilage of septum is short in supply.  Thus, other options must be thought of, these alternatives are use of outer table cranial bone, iliac bone, conchal cartilage or the rib cartilage. However, certain type of body cartilage shows considerable resorption over a period of time and hence is not recommended in revision rhinoplasty. However, certain alloplastic substances like Mersilene, Medpor, Proplast and Supramid have shown up good achievement rates but the risks involved are of prolonged swelling, infection or non-acceptance by the body.
Rhinoplasty surgery procedure is basically same for men and women. But if the surgeon doesnot take into consideration the differences in male nose versus the female nose, a need for revision rhinoplasty in men arises.
The rates of revision rhinoplasty vary from 5% to 20%. On an average 5-10% of the rhinoplasty patients go for revision rhinoplasty and 1-3% go for multiple revision surgery. The deformities of post-rhinoplasty patients include saddling, pollybeak, and midnasal asymmetry, hanging columella, wide base, withdrawn columella, uneven or elevated dorsum, implant modification and severe nasolabial angle.

Summary: The problems arising out of a rhinoplasty procedure lead to a secondary surgery, the revision rhinoplasty. Generally, it cures the deformaties of post-rhinoplasty patients and is done to meet their expectations.